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ObjectiveTo investigate the effect and mechanism of Shuxuetong and its main component hirudin on the apoptosis of cerebellar granule neurons （CGNs） in Sprague-Dawley（SD） rats. MethodsCGNs incubated in vitro for 7 days were divided into survival control group or 25 K group （cultured in medium containing 25 mmol/L KCL） and apoptosis group or 5 K group （cultured in medium containing 5 mmol/L KCL）. CGNs were separately treated with proportionally diluted and different concentrations of Shuxuetong （1/50， 1/40， 1/30， 1/20 and 1/10） and the corresponding different concentrations of hirudin （2， 2.5， 3.34， 5 and 10 U / mL）. Hoechst staining was performed to analyze the apoptosis. Western blot was used to detect the expression levels of Cleaved Caspase-3， Bim and VEGF. ResultsHoechst staining showed that 5 K group had a higher apoptosis rate than 25 K group. In 25 K group， there was no significant change in the apoptosis rate between neurons treated with different concentrations of Shuxuetong and hirudin， but significant changes was found in 5 K group and the higher the concentration， the lower the apoptosis rate. Western blot results revealed that， compared with control neurons in 5 K group， Shuxuetong injection and hirudin treatments resulted in a decrease of Cleaved Caspase-3 and Bim expression， but an increase of VEGF protein. ConclusionsShuxuetong and its main component hirudin inhibits the apoptosis of CGNs through suppressing proapoptotic BH3-only protein Bim.
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Objective:To investigate the value of high-frequency ultrasound and shear wave elastography in preoperative evaluation of basal cell carcinoma (BCC) .Methods:A total of 95 patients with histopathologically confirmed cutaneous BCC were enrolled from Department of Dermatology, Hospital of Traditional Chinese Medicine of Zhongshan from January 2017 to December 2020, all of whom had underwent preoperative conventional ultrasonography and shear wave elastography. Conventional ultrasonography parametres including the maximum diameter, maximum infiltration depth, maximum blood flow velocity and resistance index were recorded, so were shear wave elastography parametres including the average Young′s modulus (Eave) , Young′s modulus standard deviation (Esd) and average Young′s modulus ratio (Eratio) . All the patients were divided into high- and low-risk BCC groups according to pathologic subtypes. Paired t-test was used to compare conventional ultrasonography and shear wave elastography findings between the 2 groups. Results:There were 15 cases in the high-risk BCC group and 80 cases in the low-risk BCC group. Compared with the low-risk BCC group, the high-risk BCC group showed significantly increased maximum depth of tumor infiltration (8.5 ± 4.6 mm vs. 4.5 ± 1.6 mm, t = 6.150, P < 0.001) , Eave (32.7 ± 11.2 kPa vs. 20.6 ± 5.1 kPa, t = 4.065, P = 0.001) and Esd (7.0 ± 4.1 kPa vs. 4.2 ± 2.1 kPa, t = 2.632, P = 0.018) , while there were no significant differences in the other measurement data between the two groups (all P > 0.05) . The areas under the receiver operating characteristic curves of the maximum infiltration depth, Eave and Esd for the diagnosis of high-risk BCC were 0.775, 0.909 and 0.822 respectively, and Eave showed the best diagnostic performance. Using 25.7 kPa as the cut-off value, the sensitivity and specificity of Eave were 86.7% and 85.0% for the diagnosis of high-risk BCC, respectively. Conclusion:High-frequency ultrasound and shear wave elastography can facilitate differential diagnosis between high- and low-risk BCC.
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Objective@#To investigate the knowledge regarding clinical research among children at 8-18 years of age. The survey results will form the basis for developing public education program for this population.@*Methods@#The survey was conducted among children at 8-18 years of age using WeChat and spot investigation between January 2016 and January 2017. According to different developmental stages, the survey population was divided into four groups: age 8-10, 11-13, 14-15 and 16-18 years. The level of knowledge regarding clinical research was analyzed.@*Results@#Totally 1 329 questionnaires were issued and 1 233 effective questionnaires were returned with a recovery rate of 92.8%. The overall awareness rate regarding clinical research was 32.8% (405/1 233) . It revealed that 282 (22.9%) individuals thought that clinical research was to treat people like experimental rats. When asked "who have the final decision on research participation", the percentages of those who chose oneself, parents or guardian and doctor were 44.6% (550/1 233), 74.2% (915/1 233) and 36.8% (454/1 233) respectively. When asked "If you want to participate a study, but your parents or guardian do not agree, what would you do?", 33.9% (418/1 233) of individuals will "give up". As to "If you do not want to participate a study, but your parents or guardian think you should, what would you do?", 51.3% (632/1 233) chose "listen to parents" and 28.8% (355/1 233) chose "refuse the suggestions of parents or guardian". As to "what are your greatest concerns of participating an investigation?" , 68.1% (840/1 233) chose "worry about added pain or discomfort". but 58.0% (715/1 233) thought if "doctors and nurses take good care of me" their "concerns will reduce" or "feel better to participate in the research?". 55.6% (686/1 233) and 49.3% (608/1 233) individuals responded that they will "participate in an research?" when they "know that other people also participate the research" and when they "know the details regarding what will happen after the enrollment".@*Conclusions@#The knowledge level of clinical research among children aged 8-18 years were not high. It is very necessary to promote the public education of clinical research for this population and also very necessary to address their concern regarding the research.
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Objective To investigate the effect of elemene and the mechanism of this effect on the proliferation of neuroblastoma.Methods We treated cultured SK-N-SH cells with elemene and used the MTT assay to determine the inhibition of cell proliferation.We used RT-qPCR and Western blotting to measure the effect of elemene on mRNA and protein expression,respectively,of repressor element-1 silencing transcription factor (REST) in SK-N-SH cells and evaluated the mRNA expression of CCND1 and CCNE1 in SK-N-SH cells by using RT-qPCR.Results Elemene significantly inhibited the proliferation of SK-N-SH cells in a dose-and time-dependent manner (P =0.001 16).Moreover,the mRNA (P =0.000 38) and protein (P =0.003 39) expression of REST were markedly suppressed by elemene.Furthermore,elemene significantly reduced the mRNA expression of CCND1 (P =0.001 91) and CCNE1 (P =0.000 15),which are related to the cell cycle.Conclusion Elemene significantly suppressed the proliferation of neuroblastoma cells through the reduction of REST,CCND1,and CCNE1.
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Objective To explore the prognostic factors of intensive care unit (ICU) patients. Methods A retrospective cohort study was conducted. The clinical data of patients admitted to ICU of Beijing Geriatric Hospital from January 2005 to December 2016 were collected. According to the prognosis, the patients were divided into death group and survival group, and the mortality trend with time and age was observed. Survival and death were treated as dependent variables, while the gender, age, reason of ICU admission, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, whether undergoing invasive mechanical ventilation (MV), invasive MV reason, duration of invasive MV, whether successful weaning, whether ICU nosocomial infection, hospital acquired pneumonia (HAP), central line-associated bloodstream infection (CLABSI), acute kidney injury (AKI) occurred, whether undergoing continuous blood purification (CBP), whether septic shock occurred, whether undergoing invasive hemodynamic monitoring or blood transfusion and length of ICU stay were used as the independent variables. First, the clinical data was analyzed by univariate analysis. Second, the independent variables influencing the dependent variable were analyzed by logistic regression analysis to screen out prognostic factors of ICU patients. Results During the study period, 1325 patients were treated, 26 patients with missing data, 1299 patients in final group, 865 patients in survival group, and 434 in death group. The proportion of men in the patients was larger (67.7%), and the age span was larger (16-105 years old). The mortality rate in different years showed no significant difference (χ2 = 16.712, P = 0.117), and with the increase of age, the mortality rate of ICU showed an upward trend (χ2 = 16.399, P = 0.022). The univariate analysis showed that ICU deaths were unrelated to gender, but associated with age, APACHE Ⅱ score, invasive MV, invasive MV reason, duration of invasive MV, successful weaning, ICU nosocomial infection, HAP, CLABSI, AKI, septic shock, whether CBP or invasive hemodynamic monitoring, blood transfusion, the reason of ICU admission and the length of ICU stay (all P < 0.05). The relevant factors with statistical difference found in univariate analysis were analyzed in logistic regression analysis, which showed that whether successful weaning [odds ratio (OR) = 0.016, 95% confidence interval (95%CI) = 0.010-0.025], and whether AKI (OR = 3.917, 95%CI = 2.331-6.582) or septic shock occurred (OR = 2.808, 95%CI = 1.604-4.915) were the dependent variables of death or survival (all P = 0.000). Regression coefficient (β value) of successful weaning was -4.155, suggesting that unsuccessful weaning patients were likely to die. The β value of AKI and septic shock was 1.365 and 1.033, suggesting that the patients with AKI or septic shock were more likely to die. Conclusions Whether the success of weaning, whether the occurrence of AKI or septic shock are independent prognostic factors for the prognosis of ICU patients. Measures for the prevention of the above three aspects could improve the prognosis of ICU patients.
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Objective To explore how the different intervention measures affect the outcome of central venous catheter-related thrombosis (CRT) in children. Methods A retrospective analysis was carried out to collect the clinical data of patients with CRT from the nursing management system of the Children′s Hospital Affiliated to Zhejiang University School of Medicine which reported by each nursing unit from January 1,2015 to December 31,2015. Results Totally 108 cases were included (72 boys and 36 girls), median age of 24.5 months (ranged from 1 month to 14 years old). Nearly 42.59% (46/108) patients suffered from neurological diseases. Nearly 55.56%(60/108) CRT was detected in the first week after catheterization. Once CRT conformed, there were four kinds clinical intervention options applied. Intervention 1: thrombolytic therapy with urokinase combined anticoagulation with nadroparin calcium. Intervention 2: anticoagulant therapy only. Intervention 3: thrombolytic therapy alone. Intervention 4: no medications. The differences of effective between the four kinds of intervention were statistically significant (χ2=13.380, P=0.004). The single-factor regression analysis was done to each relevant factor. Finally the multivariate regression analysis showed four factors had impacts upon the results. The factors were as follows:gender (OR=10.400, 95%CI 1.879-57.563, P=0.007);interval (OR=1.107, 95%CI 1.035-1.184, P = 0.003), size of thrombus(OR = 1.562,95%CI 1.033-2.362,P=0.035; Intervention 2 (OR =11.757, 95% CI 2.254- 61.327, P = 0.003), intervention 4 (OR = 35.397, 95% CI 3.493-358.760, P =0.003). Conclusions The earlier and small size thrombus is more soluble. Thrombolytic therapy or combined anticoagulation is more effective. It is recommended that if no contraindications presents, thrombolytic combined with anticoagulant therapy should start early standardized treatment.
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Objective To study the closure time of neonatal ductus venosus and the Z score regression equation, and to explore the variation of closure time of neonatal ductus venosus with gestationalage.Methods Color doppler ultrasound was applied to detect the closure time of neonatal ductus venosus in normal newborns, Z score regression equation ( lnY =a +bX +cX2 ) for the closure time of neonatal ductus venosus ( Y ) was developed by regression analysis which used gestational age ( X) as an independent variable. The Z scores of the closure time of neonatal ductus venosus in different gestational age were calculated by the formula [ Z = ( M - Y )/S x , M for observation value, Y for predictivevalue].Results There were 432 cases in our study.The closure time of neonatal ductus venosus was negatively related to gestational age ( r = -0. 938 , P <0. 001 ) . The nonlinear regression equation was lnY= -5. 228+0. 089X-0. 000228X2, R2 =0. 854, Sx =0. 214(P<0. 001). Based on the predicted mean of the closure time and Sx related to different gestational age, Z scores for specific closure time of neonatal ductus venosus could be calculated by the formula [ Z =( M -Y)/Sx ] . The Z scores were normally distributed,and did not change with gestational age.Conclusions Theclosure & nbsp;time of neonatal ductus venosus is negatively related to gestational age. The Z scores obtained by the predicted nonlinear regression equation are normally distributed.
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Objective To identify the association between body temperature and neurological outcome in post-arrest patients.Methods This was a multicenter,retrospective cohort study.In the period 1990-2011,a total of 184 patients resuscitated from IHCA with ROSC for more than 20 min were included.Data were collected according to Utstein style.The primary endpoint was hospital dis-charge with good neurological function (Cerebral Performance Category,CPC,1-2).Multivariate Lo-gistic regression was performed to determine the association between body temperature and neurologi-cal outcome.Results Among the 184 enrolled patients,37.0% (68/184)survived to hospital dis-charge,19.6% (36/184)survived to discharge with favorable neurological outcome(CPC,1-2).Mul-tivariate Logistic regression revealed that maximal body temperature between 35.5℃ and 38.4℃ was associated with favorable neurological outcomes (OR=8.986,95% CI 1.156-69.882;P =0.036). Conclusion For IHCA patients achieving spontaneous circulation, maximal body temperature between 35.5℃ and 38.4℃ in the initial 24 h following admission to ICU was associated with favora-ble neurological outcome.
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Objective To assess the safety and efficacy of stent-assisted coil embolization for acutely ruptured wide-necked intracranial aneurysms. Methods We retrospectively reviewed 192 wide-necked intracranial aneurysms in 178 patients. The efficacy and peri-procedure complications of stent-assisted embolization were compared between rup?ture aneurysms and unrupture aneurysms. Results Stent was successfully implanted in 78 rupture aneurysms and 114 un?rupture aneurysms. There was statistically significant difference between rupture aneurysms and unrupture aneurysms groups in rate of poor prognosis on discharge ( 23.1%vs. 5%,χ2=12.726, P0.05)nor in the rate of mortality and permanent disability (8.9%vs. 6.1%,χ2=0.475, P>0.05). Angiograms at 14.7 months of follow-up did not reveal any significant difference between rupture aneu?rysms and unrupture aneurysms groups in aneurysm complete occlusion (74.1%vs. 70.6%,χ2=0.197,P>0.05), recana?lization (10.3%vs. 9.4%,χ2=0.034,P>0.05)and in-stent stenosis (3.4%vs. 4.7%,χ2=0.136,P>0.05). Conclusion Stent-assisted coil embolization for acutely rupture wide-necked intracranial aneurysms can prevent recurrence effective?ly and can achieve high complete occlusion rate in long term follow-up. However, its procedure related complications and mortality is higher in rupture aneurysms than in unrupture aneurysms, which indicates that a caution is needed to conduct stent-assisted coil embolization in rupture aneurysms.
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Objective To investigate the effect of Dan-Hong injection on peripheral neuropathy in experimental rats with type Ⅰ diabetes.Methods Forty Wistar male rats were chose in our study and divided into Dan-Hong injection group,mecobalamin treatment group,model group and normal control group (n=10);rat models of type Ⅰ diabetes in the first three groups were induced by intraperitoneal injection of streptozotocin.Different drugs were given to these rats,and 12 weeks after model making,the blood glucose level and the body weight were measured;footprints gaits were analyzed;nerve conduction velocity was observed;immumohistochemical staining and HE staining were employed to detect the pathological alterations of intraepidermal nerve fiber and peripheral nerve tissues.Results As compared with model group,rats in Dan-Hong injection group had increased nerve conduction velocity and footprint parameters with statistical differences ([62.05±5.45] m/s vs [37.72±4.06] m/s;[22.00±0.34] mm vs [22.74±0.19] mm;[10.79±0.22] mm vs [11.49±0.14] mm;[17.50±0.16] mm vs [17.67±0.17] mm) (P＜0.05).The number of intraepidermal nerve fiber was increased and the pathological damage of peripheral nerves was obvious improved in the Dan-Hong injection group as compared with those in the model group;the nervous tissues showed edema with myelin fuzzy and swelling of the axon,which had been much improved as compared with those in the model group.Conclusions Dan-Hong injection can prevent and improve peripheral neuropathy of rats with type Ⅰ diabetes.
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Objective To investigate the mechanism of histone deacetylase inhibitors in proliferation ofglioma cells.Methods (1) Glioma cell line U251 was cultured in vitro and treated with Trichostatin A (TSA) at 0.1,0.2,0.5,1.0 or 2.0 μmol/L for 48 h to determine the IC50 for TSA,and then,cells were treated with TSA at the IC50 concentration (0.5 μ mol/L) for 8,16,24,48 h;1 μmol/L M344,0.5 μmol/L LBH589,6 mmol/L NaBu and 6 mmol/L VPA were used to treat the cells for 48 h and same volume of solvent was given to cells for 48 h as control group;MTT assay was performed to determine cell viability.(2) Western blotting was performed to test the Jun N-terminal kinase (JNK)expression and phosphorylated JNK (p-JNK) level in the U251 cells after being treated with 0.5 μmol/L TSA for 8,16 and 24 h.(3) Western blotting and MTT assay were employed to detect the c-Jun expression and phosphorylated c-Jun (p-c-Jun) level,and cell viability in the U251 cells of control group,10 μmol/L SP600125 treatment group (JNK inhibitor) and 1 μmol/L CEP11004 treatment group (MLK3,a direct upstream kinase of JNK).(4) Western blotting and MTT assay were employed to detect the c-Jun and Flag expressions,and cell viability in the U251 cells of pcDNA3.1 transfected group,pcDNA3.1+TSA transfected group,pMKK7-JNK1 transfected group and pMKK7-JNK1+TSA transfected group.Results (1) The viability of cells of 0.1,0.2,0.5,1.0 or 2.0 μmol/L TSA treated group was significantly lower than that in the control group,and the higher the TSA concentration,the lower the viability of cells;the viability of cells of 0.5 μmol/L TSA treated for 16,24,36 and 48 h groups was significantly lower than that in the control group,and the longer the TSA treatment,the lower the viability of cells.(2) The viability of 1 μmol/L M344,0.5 μmol/L LBH589,6 mmol/L NaBu and 6 mmol/L VPA treatment groups was significantly lower than that in the control group (P＜0.05).(3) As compared with those in the control group,the p-JNK expression was significantly decreased in the cells after 0.5 μmol/L TSA treatment for 16 and 24 h,and the p-c-Jun protein expression and the cell viability were significantly decreased in the cells of 10 μmol/L SP600125 and 1 μmol/L CEP11004 treatment groups (P＜0.05).(4) As compared with that in the pcDNA3.1 transfected group,cell viability in the U251 cells ofpcDNA3.1+TSA transfected group,pMKK7-JNK1 transfected group and pMKK7-JNK1+TSA transfected group was significantly increased(P＜0.05).Conclusion Histone deacetylase inhibitors reduce the proliferation of glioma cell U251 through inhibiting JNK activity.
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Objective To investigate the promotion effect of Danhong injection (DH) on brain-derived neurotrophic factor (BDNF) expression in Schwann cells (SCs) of SD rats.Methods In experiment of SCs apoptosis induced by advanced glycation end products (AGEs),SCs were divided into control group,AGEs treatment group and DH+AGEs treatment group; 48 h after each treatment,the SCs count was compared.In experiment of DH affecting mRNA and protein BDNF expressions in SCs,real time-PCR and Western blotting were used.In the experiment of DH combined with different inhibitors (Calphostin C,LY294002,H89,U0126,FR180204 and SB203580) affecting mRNA BDNF expression in SCs,real time-PCR was used.Results The number of SCs in AGEs treatment group was significantly decreased than that in the control group,but that in DH+AGEs treatment group was statistically increased than that in AGEs group (P＜0.05).The mRNA and protein expressions of BDNF in the DH treatment group were significantly increased than those in the control group (P＜0.05).As compared with DH group,DH+Calphostin C treatment group had significantly decreased BDNF mRNA expression (P＜0.05); BDNF mRNA expression in the DH+U0126,DH+FR180204 and DH+SB203580 treatment groups was significantly decreased as compared with that in the DH treatment group (P＜0.05).Conclusions DH could effectively inhibit SCs apoptosis induced by AGEs and significantly promote BDNF expression;protein kinase C (Calphostin C) and mehtyl ethyl ketone (U0126)/extracellular regulated protein kinases (FR180204EK)/p38 (SB203580) may be the important signaling transconduction pathways for BDNF expression.
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Objective To investigate the roles ofc-Jun/Fra1 dimer in viability ofdopaminergic neurons.Methods (1) Dopaminergic neuron-like cell line SH-SY5Y was cultured in vitro.Cells were lysed for immunoprecipitation to determine whether c-Jun dimerized with Fra1.(2) Cells received treatments were divided into four groups:Jun N-terminal kinase (JNK) inhibitor SP600125 treatment group,mitogen-activated kinase (MEK) 1/2 inhibitor U0126 treatment group,SP600125+U0126 treatment group and control group (treated with dimethyl sulfoxide [DMSO]).Western blotting was performed to detect the c-Jun and Fral expression levels and MTT assay was used to observe the cell viability.(3) Cells infected with adenovirus (Ad) carrying c-Jun or Fra1 genes were divided into three groups:Ad-c-Jun group,Ad-Fra1 group and Ad-c-Jun+Ad-Fra1 group,and cells transfected with GFP were used as control group; immunofluorescence and MTT assay were performed to determine the infectious rate and the cell viability,respectively.Results (1) Co-immunoprecipitation showed that the c-Jun dimerized with Fral in SH-SY5Y cell line.(2) Western blotting indicated that inhibition of JNK by SP600125 reduced c-Jun expression and MEK1/2 by U0126 inhibited Fra1 expression; MTT assay indicated that there were significant differences in the cellular viability among the four groups (F=16.647,P=0.000),the cellular viability in control group obviously differed from that in SP600125 treatment group,U0126 treatment group or SP600125+U0126 treatment group (P＜0.05).(3) Immunofluorescence showed that most of cells infected by adenovirus expressed c-Jun or Fra1.MTT assay indicated that there were significant differences in the cellular viability among the four groups (F=14.543,P=0.000),and there were significant differences in their viabilities between control group and Ad-Fra1 group,and between Ad-Fra1 group and Ad-Fra1+Ad-c-Jun group (P＜0.05).Conclusion The c-Jun and Fra1forming a dimer promotes the viability of dopaminergic neuron-like cells.
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Objective To investigate the Du moxibustion therapy in the treatment of chronic obstructive pulmonary disease (Chronic obstructive pulmonary disease,COPD)at stable phase.Methods 60 cases of lung COPD patients in stable stage who received treatment from January to December 2010 in Taihe Hospital of Traditional Chinese Medicine outpatient were randomly divided into two groups in,according to the case of tail number,with 30 patients in each.The control group was taken oral doxofylline tablets,0.2 g/time,2 time/d and ambroxol hydrochloride,30 mg/time,3 time/d.The treatment group was treated with Du moxibustion two times on the basis of the control group.One year follow-up and pulmonary function and BODE index assessment were performed in each group.Results ① the pulmonary function of the treatment group after the treatment (65.58±7.90) ％ was significantly improved than the same group before the treatment (53.20± 7.37) ％ (P＜0.05),and had significant difference compared with the control group after the treatment (57.53 ± 7.22)％ (P＜0.05).The recurrence rate was significantly different in the treatment group (1.79±0.32) and the control group (2.09±0.38) (P＜0.05).② BMI,MMRC,6MWD,BODE index,shortness of breath,wheezing,anorexia was significantly improved after the treatment in the treatment group [after treatment were (21.98 ± 1.32)kg/m2,(2.09±0.37)％,(350.68±88.70),(3.82±2.18) meters,(0.38±0.27),(0.32±0.25)％,(0.35±0.27) respectively; before treatment were (18.21±2.49)kg/m2,(2.50±0.43)％,(324.88±70.92),(4.66±1.40) meters,(1.49±0.62) ％,(1.42±0.56)％,(1.77±0.35),P＜0.01 respecitively].Compared with the control treatment after the treatment [(18.20 ± 1.79) kg/m2,(2.36 ± 0.64) ％,(320.03 ± 68.53),(4.43 ±1.62) meters,(1.22± 0.71),(1.28±0.67)％,(1.73±0.24) respectively] (P＞0.01),the difference was statistically significant(P＜0.01).Conclusion Du moxibustion therapy was effective in treating chronic obstructive pulmonary diseases in stable phase.
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Objective To measure the changes of total factor productivity (TFP)of Zhejiang medical facilities for decision makers to promote their service efficiency.Methods Collecting the panel data of 2005-2010(four input indexes and five output indexes)from medical facilities in Zhejiang province and measuring with Malmquist index of DEA programs of DEAP2.1.Results The average annual TFP growth rate in the period is 2.0％.A further decomposition found that the average annual growth rate of technology progress is 1.8 ％,while that of technical efficiency and pure technical efficiency is only 0.2％respectively.In the meantime,no scale efficiency growth was found.Conclusion The average annual growth of total factor productivity of Zhejiang medical institutions is substantially low in the period,with technology recession found as well.To maximize productivity of the medical sector,the allocation and internal management should be strengthened to stimulate technical efficiency and scale efficiency while encouraging technology innovation.